Town of Vidalia

Primary specialty

AmbulanceTaxonomy code 341600000X

License

9110062 Issued in LA

Legal business name

TOWN OF VIDALIA

Practice address

204 Vernon Stevens Blvd
Vidalia, LA 71373-5001

Phone

(318) 336-6262

NPI assigned

Feb 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matt Taunton

Title

EMS Director

Phone

(318) 336-6262

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1083758668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713732010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 VERNON STEVENS BLVD",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713735001",
            "telephone_number": "318-336-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF VIDALIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "TAUNTON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "318-336-6262"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "LA",
            "license": "9110062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "C8277",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590012309",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1697516",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynncoy Thornburg
• Tillman Medical Group PA
• Barry Forrest Tillman, M.D.
• Clifford Randolph Tillman
• Total Urgent Care
• Dominique Trimble
• Brittany Tyler
• Vicksburg Clinic LLC
• W . Jarrod Gregg, DDS, LLC
• Wal-Mart Stores East LP

• Ambulance in Vidalia, LA
• Providers in Vidalia, LA by specialty
• Ambulance in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.